| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 100 SUMMIT LAKE DRIVE, SUITE 400 VALHALLA, NY 10595 | EMBLEM HEALTH, INC. | $18K | $0 | $18K | 1.34% |
| USI INSURANCE SERVICES LLC3 | 725 RXR PLAZA, EAST TOWER UNIONDALE, NY 11556 | EMBLEM HEALTH, INC. | $5K | $0 | $5K | 0.38% |
| USI INSURANCE SERVICES LLC3 | 300 EXECUTIVE DRIVE WEST ORANGE, NJ 07052 | HORIZON HEALTHCARE SERVICES, INC. | $11K | $0 | $11K | 1.69% |
| USI INSURANCE SERVICES LLC3 | 333 WESTCHESTER AVENUE WHITE PLAINS, NY 10604 | AETNA LIFE INSURANCE COMPANY | $31K | $48 | $31K | 10.88% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62689 VIRGINIA BEACH, VA 23466 | HARTFORD LIFE AND ACCIDENT | $5K | $4K | $9K | 3.02% |
| USI INSURANCE SERVICES LLC3 | 2400 EAST COMMERCIAL BOULEVARD SUITE 600 FORT LAUDERDALE, FL 33308 | HARTFORD LIFE AND ACCIDENT | $133 | $76 | $209 | 0.07% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN INC | $4K | $0 | $4K | 1.69% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62689 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $8K | $0 | $8K | 14.60% |
No Schedule C service providers reported on this filing.
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 940 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 940 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | EMBLEM HEALTH, INC. | 137 | $2.3M |
| Dental | AETNA LIFE INSURANCE COMPANY | 1,164 | $287K |
| Vision | VISION SERVICE PLAN | 374 | $55K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 940 | $283K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 940 | $283K |
| Prescription drug(3 contracts, 3 carriers) | EMBLEM HEALTH, INC. | 137 | $2.3M |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 940 | $286K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,164 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.